Russians discover the next big thing: teeth

MOSCOW -- Yekaterina Tkalenko brushes her teeth three or four times a day - especially after drinking enamel-insulting tea or coffee - has them professionally cleaned twice a year and carries floss as if it were as vital as an inhaler. She recently spent nearly $1,000 to have her teeth whitened.

"When I look at a person, no matter who it is, the first thing I look at is his or her teeth and their smile," said the 34-year-old Muscovite, who works in the tourist industry. "When I see good teeth, I think this person has more chances in life, and he'll be more successful than a person who has bad teeth."

In a nation where, a generation ago, a trip to the dentist happened only when a tooth hurt, families shared toothbrushes, and dental floss was but a curiosity, oral hygiene is the new vogue. And good teeth - or at least straight, white ones - are as important a part of one's image in wealthy cities like Moscow as the proper shade of lipstick or the perfect pair of heels.

Soviet-era teeth were notoriously bad. In 1991, the average 35-year-old had 12 to 14 cavities, fillings or missing teeth, said Vladimir Sadovsky, vice president of the Russian Dental Association (not counting wisdom teeth, adults have 28).

Toothpaste meant whatever was available. Toothbrushes had hard bristles that cut the gums, sometimes doing more harm than good. Dental technologies were years behind those of the West; the 17-year-old who was crowned Miss U.S.S.R. in 1990 flew to Philadelphia the same year to have the gap in her teeth closed and a few cavities filled.

But the domestic oral hygiene market has exploded in recent years. Private dental clinics in central Moscow, which have new equipment far surpassing the quality in under-funded municipal clinics, are practically around every corner. Pharmacy shelves are stocked not just with the latest blends of imported Colgate and Aquafresh, but yogurt-based paste and paste in flavors like Jazz of Lemon Mint. There are also anti-plaque rinses, fresheners, round flosses, flat flosses, whitening strips, whitening gels and whitening plates, among other things.

According to industry estimates, sales of oral hygiene products in Russia have nearly doubled since 2000. From 2005 to last year, Russians boosted spending in the sector by an estimated $170 million, to $1.43 billion, according to the online newsletter Cosmetics in Russia, citing statistics from Euromonitor International. More people are willing to purchase high-end items, including electric toothbrushes and Rembrandt toothpaste, which can cost as much as $14 a tube. Tkalenko, a self-described oral hygiene addict, uses another foreign brand that goes for $19.

"Now the population is well aware of one fact: If you want to be successful, say, in business, you have to have a healthy smile," said Andrei Akulovich, a dentist in Saint Petersburg who is editor of the newspaper Stomatologiya Sevognya, or Dentistry Today.

In the 1980s, he said, federal statistics showed that one-quarter of households in Russia had only one toothbrush. And even now, amidst the tooth obsession sweeping some cities, the average per capita spending on toothpaste -- per year -- is the equivalent of $3.80. That still means a lot of tooth decay.

Still, it's not unusual for women, and even some men, to keep floss in their purse (though not all know that using it at the dinner table is uncivilized). And, in large part because of an education campaign in schools, the importance of good oral hygiene is being drilled in at a young age: In a recent art contest in which children illustrated their view of the Russian president, a 9-year-old girl drew a pajama- and slipper-clad Vladimir V. Putin brushing his teeth in front of the mirror (alongside a toilet made of gold).

Fluoride in the water still is viewed with skepticism here; one Moscow dentist said it causes people's teeth to turn brown, and a major water supplier stopped selling it last year because, the company said, clients could get enough "from food" and "in the air." Still, the Russian government has funded the fluoridation of milk in some municipalities, and with good result. In the southern city of Voronezh, the average 12-year-old had nearly 4 cavities in 1994, the year the fluoridation campaign began, said Sadovsky. By 2004, the number of cavities was 1.5.

In the United States, by contrast, nearly 60 percent of those from 6 to 19 years of age have never had a cavity in their permanent teeth.

"In 1991, they didn't know what a dental hygienist was. They didn't know what dental floss was," said Giovanni Favero, an American dentist who trained Russians in the early days after the collapse of the Soviet Union and founded the American-Russian Dental Center in central Moscow, where he has worked for 12 years. "Dentists never told a patient to come if it didn't hurt. Now the general population has learned there's a different way."